AIMS To evaluate the effectiveness of home visiting programmes on parenting and quality of the home environment.

DESIGN Systematic review of the literature of randomised controlled trials and quasi-experimental studies evaluating home visiting programmes involving at least one postnatal visit.

SUBJECTS Thirty four studies reported relevant outcomes; 26 used participants considered to be at risk of adverse maternal or child health outcomes; two used preterm or low birth weight infants; and two used infants with failure to thrive. Only eight used participants not considered to be at risk of adverse child health outcomes.

RESULTS Seventeen studies reported Home Observation for Measurement of the Environment (HOME) scores, 27 reported other measures of parenting, and 10 reported both types of outcome. Twelve studies were entered into the meta analysis. This showed a significant effect of home visiting on HOME score. Similar results were found after restricting the analyses to randomised controlled trials and to higher quality studies. Twenty one of the 27 studies reporting other measures of parenting found significant treatment effects favouring the home visited group on a range of measures.

CONCLUSIONS Home visiting programmes were associated with an improvement in the quality of the home environment. Few studies used UK health visitors, so caution must be exercised in extrapolating the results to current UK health visiting practice. Further work is needed to evaluate whether UK health visitors can achieve similar results. Comparisons with similar programmes delivered by paraprofessionals or community mothers are also needed.

https://adc.bmj.com/content/archdischild/82/6/443.full.pdf

Does home visiting improve parenting and the quality of the home environment? A systematic review and meta analysis

Background
Parental and child psychiatric disorders have been found to be associated, and this association can be mediated by other psychosocial variables, including parenting attitudes and strategies. As most previous studies included clinical samples, the purpose of this study was to establish the relationship between parental psychopathology and parenting strategies with child psychiatric disorders in a national survey population.

/pdf/relationship-between-parental-psychopathology-parenting-bvqa3sfz6a.pdf

Relationship between parental psychopathology, parenting strategies and child mental health--findings from the GB national study.

Aim: To explore whether changes in parenting self-efficacy after attending a parenting programme are related to changes in parenting stress and child behaviour. Background: Adverse parenting is a risk factor in the development of a range of health and behavioural problems in childhood and is predictive of poor adult outcomes. Strategies for supporting parents are recognised as an effective way to improve the health, well-being and development of children. Parenting is influenced by many factors including the behaviour and characteristics of the child, the health and psychological well-being of the parent and the contextual influences of stress and support. Parenting difficulties are a major source of stress for parents, and parenting self-efficacy has been shown to be an important buffer against parenting stress. Methods: In all, 63 parents who had a child under the age of 10 years took part in the research. Of those, 58 returned completed measures of parenting self-efficacy, parenting stress and child behaviour at the start of a parenting programme and 37 at three-month followup. Findings: Improvements in parenting self-efficacy and parenting stress were found at follow-up, but there was less evidence for improvements in child behaviour. The findings clearly suggest a relationship between parenting self-efficacy and parenting stress; parents who are feeling less efficacious experience higher levels of stress, whereas greater parenting self-efficacy is related to less stress. This study adds to the evidence that parent outcomes may be a more reliable measure of programme effectiveness than child outcomes at least in the short term.

/pdf/parenting-self-efficacy-parenting-stress-and-child-behaviour-4pio824892.pdf

Parenting self-efficacy, parenting stress and child behaviour before and after a parenting programme.

Adverse experiences in early childhood and their longitudinal impact on later behavioral problems of children living in poverty.

Objective: To provide an overview of the literature relevant to, and describing, parenting programs for women with mental illness who have young children.Method: A literature search was undertaken, including MEDLINE, PsycINFO, CINAHL, Cochrane Database of Systematic Reviews and EMBASE: Psychiatry. Searches were limited to English journals and books and to the last five years in the first instance, with earlier literature considered where appropriate.Results: Maternal mental illness can impact negatively on a child's life, especially where an insecure attachment is formed between mother and baby during the important early developmental years. The potential sequelae of maternal mental illness for children include impaired cognitive development, behavioural difficulties and increased risk of psychiatric disorder. Effective parenting skills are suggested to be a protective factor against these sequelae. However, the effects of parenting programs for women with mental illness have not been empirically tested, ...

Parenting programs for women with mental illness who have young children: a review.

The way parents bring up their children has become a matter of increasing public and professional concern. There is strong interest in defining the elements of successful parenting so that all parents can help their children reach their potential and lead a fulfilling life. There is also a drive to prevent parenting failure and family breakdown, especially as manifested by child abuse and the rising tide of antisocial behaviour in children and young people.

In recent years the number of programmes and approaches for improving parenting has mushroomed.1 Some cater for basically competent parents while others target those at high risk of parenting failure and family breakdown. This article describes the nature and effectiveness of a programme for parents who are experiencing serious difficulty looking after and controlling children aged 3–8 years.

It is useful to distinguish between support for parents and support for parenting. General characteristics of parents such as being single and alone, poor, in a rough neighbourhood, a drug addict, of limited intellect, depressed, etc, make it harder to bring a child up successfully. However, if these adversities can be managed so that the immediate quality of parenting behaviour is adequate, the outcome for the children is not compromised.2 Several community studies have shown that it is the quality of the immediate moment to moment behaviour of the parent towards the child that has the major influence on the child’s wellbeing rather than the circumstances per se.3 These findings allow cautious optimism, insofar as there is no inevitably bad outcome for children brought up by parents who have to cope with stressful circumstances or mental illness.

There is now overwhelming evidence that particular parenting styles are harmful for children and are particularly associated with antisocial child behaviour.4 5 These are: a persistently hostile, …

https://adc.bmj.com/content/archdischild/79/1/90.full.pdf

Stephen Scott

Papers

Intensive interventions to improve parenting